Guerguis Professional Dental, INC.
Clinic/Center, Dental in Cerritos, CA. Organization (NPI-2).
NPI number1578024691
StatusActive
Last updated in NPPESMar 29, 2019
Details
- NPI
- 1578024691
- Entity type
- Organization (NPI-2)
- Legal business name
- Guerguis Professional Dental, INC.
- Organization subpart
- No
- Enumeration date
- Mar 29, 2019
- Last updated
- Mar 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Bloomfield Dental Center (Doing Business As)
Practice location
12657 166th StCerritos, CA 90703-2101
Phone 562-926-6502
Mailing address
12657 166th StCerritos, CA 90703-2101
Phone 562-926-6502
Authorized official
Ihaab Wadie Guerguis
President
5629266502
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